Intrauterine device inserter

ABSTRACT

An inserter for an intrauterine device is shaped with a slender, elongated body and includes at one end thereof means whereby the intrauterine device may be firmly retained upon the inserter. Rotation of the inserter relative to the intrauterine device effects release of the intrauterine device from the inserter thereby permitting unobstructed withdrawal of the inserter with the intrauterine device being left in place within the uterine cavity. The inserter is particularly suitable for use with an intrauterine device comprising a ring and an attached membrane extending thereacross. With the intrauterine device in the mounted position, notch means on one side of the inserter engage the ring with the membrane extending about the opposite side of the inserter.

l United States Patent [1 1 Lerner -Nov. 13, 1973 INTRAUTERINE DEVICEINSERTER Primary Examiner-Richard A. Gaudet Assistant Examiner-G. F.Dunne 75 Inet Ir inS.L G h,C I v n or w emer Attorney-Strauch, Nolan,Neale, Nies & Kurz [73] Assignee: A. H. Robins Company,

Incorporated, Richmond, Va. [57] ABSTRACT [22] Filed: 1970 An inserterfor an intrauterine device is shaped with a [21] APP] 87,663 slender,elongated body and includes at one end thereof means whereby theintrauterine device may be 7 firmly retained upon the inserter. Rotationof the in- [52] 128/127 serter relative to the intrauterine deviceeffects release CL of the intrauterine device from the inserter therebyFleld of Search permitting unobstructed withdrawal of the inserter128/260, 361, 303, 323; 152/370; 206/46 6 with the intrauterine devicebeing left in place within 56 R t Ci d the uterine cavity. 1 e erenceste The inserter is particularly suitable for use with an UNITED STATESPATENTS intrauterine device comprising a ring and an attached 2,176,55910/1939 Meckstroth 128/130 m mbrane extending thereacross. With the sqlintrauterine device in the mounted position, notch means on one side ofthe inserter engage the ring with 3,174,525 3/1965 Brose 152 370 themembrane extending about the opposite Side of the inserter.

15 Claims, 11 Drawing Figures PATENTEDrmv 13 ms SHEET 10? 2 4 INVENTOR IIRWIN s.- LERNER ATTORNEYS PATENTEUHUV13 mm 3771; 520

SHEET 2 BF 2 INVENTOR mwm s. LERNER ATTORNE) INTRAUTERINE DEVICEINSERTER BACKGROUND OF THE INVENTION 1. Field of the Invention Thepresent invention pertains generally to contraceptive devices, and moreparticularly to an instrument for insertion of an intrauterine device.

2. Discussion of the Prior Art Among the several female contraceptivedevices presently in use most extensively, the intrauterine device ranksas of significant importance. Recent improvements-in their performanceresulting from contemporary, more sophisticated intrauterine devices,has enhanced acceptance of this form of contraception and furtherextended its utilization.

With use of intrauterine devices, there have been recently reportedpregnancy rates which are superior to sequential oralcontraceptives andonly slightly inferior to the protection afforded by combined oralcontraception. Furthermore, many of the problems and complicationshistorically attendant the use of intrauterine devices have beenreportedly greatly reduced with certain new types of the device.Reduction or elimination of these problems, which have includedbleeding, inadvertent expulsion sometimes caused by contractions of theuterine wall, and strangulation of portions of the intestines whichbecome lodged within the device, combined with improved performancecould readily operate to advance the intrauterine device to theforefront of modern day contraceptive methods.

Its potential for primacy among contraceptive implements will perhaps bebetter appreciated from consideration of the inherent advantages of theintrauterine device. No requirement for periodic reminders, such as totake a pill or for other action, exists with the intrauterine device.There is no danger of side effects from utilization could induce somehesitancy regarding its acceptance, it will be appreciated that themeans utilized could be a crucial factor in the development of theintrauterine device toward more widespread use.

- Generally, intrauterine device insertion means should enable accurate,secure placement without discomfort to the user. During the insertionprocess, the insertion means should provide firm and positive guidanceof the intrauterine device until it has been properly located within theuterine cavity, whereupon there must occur appropriate disengagement andwithdrawal of the insertion means. This should occur without disturbingthe position of the intrauterine device and without distress to theuser.

An additional advantage may be gained with an inserter which does notrequire both hands in its operation. Insertion usually involves grippingand straightening of the cervix in order to locate the outer cervical 0sand to facilitate entry through the cervical canal. This gripping isperformed with a tenaculum, and if the intrauterine device inserter maybe operated with one hand only, the other hand of the operator may befree and available to manipulate the tenaculum.

Accordingly, it will be seen that much of the potential for success ofthe intrauterine device may depend upon development of appropriate meansfor insertion. Provision of a insertion instrument which enablesachievement of all the necessary functions for intrauterine deviceplacement without introduction of detriments will, therefore, be animportant contribution to the state and development of the art ofcontraception.

SUMMARY OF THE INVENTION Briefly, the present invention may be describedas an inserter for an intruterine device comprising a slender elongatedbody, and means proximate one end of said body for retaining anintrauterine device fixed thereupon, said retaining means beingconfigured to effect release of said intrauterine device upon relativerotation between said body and said intrauterine device. In thepreferred embodiment of the invention, the specific structure for saidretaining means comprises notch means on one side of said elongated bodyand means preventing relative lateral movement of the intrauterinedevice relative to the inserter, but pennitting relative rotational andlongitudinal motion therebetween.

The inserter of the present invention is particularly suitable for usewith an intrauterine device comprising a ring and an attached membraneextending thereacross which is maintained fixed upon the inserter byengagement of the ring within said notch means with said membraneextending about the opposite side of i said inserter. For release of theintrauterine device, the inserter is rotated to disengage the ring fromthe notch means and then longitudinally withdrawn.

BRIEF DESCRIPTION OF THE DRAWINGS thereon and being positioned withinthe uterine cavity;

FIG. 7 is a sectional view taken along the line 7--7 of FIG. 6; and

FIG. 8 is a side elevation depicting disengagement of the inserter fromthe intrauterine device by relative rotation therebetween from theposition depicted in FIGS. 6 and 7.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS at its forwardextremity with a curved tip 16 configured to provide purchase when avery tightly closed cervical os is encountered during insertion. As bestseen in FIGS. 2 and 4, the entire forward end 12 of the inserter 10,extending from the curved tip 16 to approximately the mid point thereof,is shaped in one plane with a gently sloping curved configuration. Thedegree of curvature of the forward end 12 facilitates the insertion ofthe intrauterine device by permitting adaption of the inserter 10 to thenormal curvature of the cervical canal.

The body of the inserter 10 extending from the curved tip 16 toapproximately a point 17 comprises a generally rectangular crosssectional configuration which, as best seen in FIG. 5, includes a pairof side walls 18 and 20 and a pair of end walls 22 and 24. From thepoint 17 to approximately a point labeled 25 the body of the inserter 10comprises a generally circular cross sectional configuration best shownin FIG. 5A. Throughout the body portion generally identified by thenumeral 25, the shape of the inserter 10 gradually changes form from thecircular configuration depicted in FIG. 5A to a generally square crosssectional configuration best shown in FIG. 5B and comprising walls 26,28, 30 and 32each having smooth rounded corners therebetween. At a point33, the body of the inserter l gradually slopes from a generally squarecross sectional configuration to a generally flat rectangular crosssectional configuration which as best shown in the sectional view ofFIG. C comprises the handle end 14.

A pair of notches 34 and 36 are formed proximate the curved tip 16 onthe side 22 of the upper forward end of the inserter 10. The notches 34and 36 are spaced apart a predetermined longitudinal distance, and theycomprise oppositely directed surfaces,'with the notch 34 having asurface 38 sloped in the direction of the curved tip 16 while the notch36 comprises a surface 40 sloped in the opposite direction toward thehandle end 14. The opposite side24 is formed with an indentation 42which extends for a longitudinal distance intermediate the distancebetween the notches 34 and 36.

The body of the inserter in the vicinity of the point 25 has affixedthereon markings 44 in the form of numerical designations indicatingdistance between the curved tip 16 and the point at which a marking 44is located. The markings 44 are similar to and conform with markingswhich are usually contained upon uteral sounds in common use especiallysuited for gynecological examination. The markings shown in FIGS. 2 and4 designate length in centimeters with the thickness of the body of theinserter 10 being varied at each level where a different marking 44 isindicated. For example, the circular body portion extending forwardly ofthe point 25 is structured to comprise length sections of differingdiameters. A forward circular section 46 of smaller diameter adjoins alower circular section 48 having a slightly larger diameter. The lowercircular section 48 comprises a marking 44 consisting of the numeral 6which indicates that the distance between the curved tip 16 and a ridge50 located at the point where the sections 46 and 48 adjoin is 6centimeters in length. Similarly, differently sized square sections 52and 54 are provided each having thereon, respectively the numericaldesignations 7 and 8 with ridges 58 and 60 resulting from the differingsection thicknesses indicating, respectively, points at which thedistance from the curved tip 16 is 7 centimeters and 8 centimeters. Thesquare section 54 has integrally formed at the forward end thereof apair of laterally extending tabs 62 and 64 to indicate a point on theinserter 10 which is 9 centimeters from the curved tip 16, with thedesignation 9 being located immediately below the tabs 62 and 64 on bothsides 28 and 32 of the square section 54. The tabs 62 and 64,althoughthey serve an additional purpose to be described hereinafter,will tend to prevent or minimize uteral perforation by limitinginsertion of the device beyond a point at which they engage the cervicalos. Although, if necessary, the tabs 62 and 64 may be brought to withinthe cervical canal, it will be found that in most cases the distancebetween the funda] wall of the uterus and the external cervical 0s doesnot exceed nine centimeters, and that the operator should, therefore, bemade aware of a deeper insertion to prevent perforation. A second pairof laterally extending tabs 66 and 68 are likewise integrally formed atthe handle end of the square section 54.

In FIGS. 6, 7 and 8, the inserter 10 of the present invention is shownin conjunction with an intrauterine device 70 which is of a specialconfiguration and which is described and claimed in copendingapplication Ser. No. 775,729 filed Nov. 14, 1968 and assigned to thesame assignee as the present invention. The intrauterine device 70 isessentially comprised of an outer ring 72 and a membrane 74 extendingacross the central portion of the ring 72. A plurality of spurs 76extend from opposite sides of the ring 72 there being five spurs 76shown on each side of the ring 72. The spurs 76 operate to preventexpulsion of the device from the uterus. The membrane 74 is providedwith an opening 78 at the forward or head end thereof and with anopening 80 at its tail end. A telltale string 82 is affixed about thering 72 for the purposes of indicating the presence of the device andalso for potential use as an aid in removing the device.

The intrauterine device 70 is affixed upon the forward end 12 of theinserter 10 by engagement of the head end and tail end of the ring 72,respectively, within the notches 34 and 36 with the membrane 74extending about the opposite side 24 in contact with the indentation 42.As best seen in FIGS. 6 and 7, the outer ring 72 comprises a head end72A and a tail end 72B. The head end 72A when engaged within the notch34 is prevented from movement in a direction toward the tail end of theintrauterine device 70 by engagement upon the forwardly sloped surface38. In a similar but reverse fashion, the tail end 728 is prevented frommovement toward the head end by engagement against the rearwardly slopedsurface 40 of the notch 36. The device 70 may be generally comprised ofa single integral piece of molded plastic material, and consequently itwill be generally resilient in nature and easily deformable for thepurposes involved in its manipulation and utilization. The notches 34and 36 are spaced apart a distance slightly greater than thehead-to-tail distance between the ends 72A and 72B of the outer ring 72.Accordingly, in order to engage the device 70 upon the notches 34 and36, the outer ring 72 must be expanded slightly thereby creating aspring force tending to contract the outer ring 72 which operates toretain the ends 72A and 728 under a slight contracting pressure inabutment with the sloped surfaces 38 and 40. This slight spring pressureprevents the ends 72A and 728 from slipping out of the notches 34 and 36and contributes toward retention of the device 70 upon the inserter 10.

In mounting the device 70 upon the inserter 10, the curved tip 16 isfirst introduced into the opening 80 in a direction, as seen in FIG. 6,over the tail end 70B and under the membrane 74. The curved tip 16 issubsequently moved through the opening 78 and over the head end 72Auntil the outer ring 72 is positioned adjacent the notches 34 and 36.The ends 72A and 72B may then be snapped into position within thenotches 34 and 36 by slightly expanding the outer ring 72 in thelongitudinal direction. Lateral movement of the device 70 isprevented'by the engagement of the membrane 74 against the side of theinserter which is opposite the side upon which the outer ring 72 isengaged within the notches 34 and 36. It will be apparent that with thedevice 70 mounted upon the inserter 10 in the manner described bothlongitudinal and lateral movement of the device 70 will be prevented andthe device 70 will then be in a position for placement within theuterine cavity by appropriate manipulation of the inserter 10.

With the intrauterine device 70 thus mounted upon the inserter 10 of thepresent invention, the combined structure may be packaged and shipped ina condition ready for immediate placement by an operator without therearising any need for manipulation or adjustment prior to placement.Furthermore, due to the particular mounting arrangement described,little or no liklihood will exist that the device 70 will becomedislodged or disoriented during shipment. The tabs 62, 64 and 66, 68 areprincipally intended for facilitating securement of the device topackaging means.

The inserter 10 is preferably formed of a somewhat stiff but relativelyflexible material such as molded plastic. In the preferred embodimentdescribed herein, the inserter 10 is formed as a unitary molded plasticpiece having sufficient flexiblity to permit the device to follow thepath of the cervical canal when the device 70 is being inserted into thecervical cavity. The size and shape of the curved tip 16 acts topredispose the cervical canal for the intrauterine device 70 whichfollows thereby permitting insertion without the need for previousdilation. With the device 70 firmly mounted upon the inserter 10 aspreviously described, the operator may manipulate the inserter 10 bygrasping the handle 14 to propel the device 70 to an appropriatelocation within the uterus 84 against the uterine wall 86. With thedevice in place within the uterine cavity as shown in FIGS. 6 and 7, theinserter 10 may be disengaged from the intrauterine device 17 by a 90rotation of the inserter 10 as indicated by the arrow 88. Rotation ofthe inserter 10 about its longitudinal axis in the manner indicated bythe arrow 88 will permit disengagement and easy withdrawal of theinserter 10 from within the uterine cavity while allowing the device 70to remain lodged therein in an appropriate position.

In FIG. 8 there is depicted the relative positioning between theinserter l0 and the device 70 subsequent to rotation of the inserter 10through a 90 angle and prior to movement of the inserter 10 in adirection for withdrawal from the uterine cavity. It will be noted thatdue to the rectangular configuration of the inserter 10 across theportion thereof in engagement with the intrauterine device 70, thedistance between the walls 22 and 24 will be greater than the distancebetween the walls 18 and 20. Accordingly, when the inserter 10 isengaged upon the device 70 in the configuration shown in FIGS. 6 and 7,the wider dimension extending between the walls 22 and 24 will be placedacross the device 70 between the ring 72 and the membrane 74. As aresult, this wider lateral dimension will operate to stretch somewhatthe device 70 thereby enhancing retention of the device 70 upon theinserter 10 during shipping and during insertion to within the uterinecavity. Upon rotation of the inserter 10 through the 90 arc indicated bythe arrow 88, the narrower dimension extending between the walls 18 and20 will be placed between the ring 72 and the membrane 74, therebyeliminating this stretching action and expediting withdrawal of theinserter 10 from within the device 70.

It should be noted that the membrane 74 may be formed in a slightlybowed configuration to insure elimination of any stretching when thenarrower dimension between walls 18 and 20 is placed across the device70. Rotation through the 90 arc of arrow 88, will cause the ends 72A and72B of the ring 72 to become disengaged from within the notches 34 and36, respectively. It will be appreciated that this will occur as aresult of abutment of the device 70 against the walls of the uterus. Forexample, as seen in FIG. 7 the device will be in abutment against thewall 86 of the uterus 84. This abutment will prevent rotation of thedevice 70 during the time that the inserter 10 is rotated as indicatedby the arrow 88. The amount of force needed to disengage the ring 72from within the notches 34 and 36 is very slight and is such as to exertvery little pressure against the walls of the uterus. When the inserter10 is rotated in the manner described, the ends 72A and 723 will besnapped out of engagement from within the notches 34 and 36 as a resultof the relative rotational motion between the inserter l0 and the device70. The relative positioning of the members immediately following thisrotation and snapping out of engagement is depicted'in FIG. 8, and withthe parts in this position the inserter 10 can be easily withdrawn fromwithin the device 70 and from the uterine cavity, with the device 70being retained in the desired position within the uterus. As a result ofthe lessened thickness between the walls 18 and 20 which will now extendacross the device 70, withdrawal of the inserter 10 without dislodgementor disturbance of the device 70 is enhanced. Of course, it will be clearthat the inserter 10 may be rotated in either direction fordisengagement and withdrawal.

During the insertion process, the markings 44 will provide an indicationof the extent to which the device has penetrated the cervical canal. Thephysical dimensioning of the inserter 10 whereby the lateral dimensionsthereof are gradually altered by the increasing thickness of thesections 46, 48, 52 and 54 will enhance the ability of the operator todetect the degree of insertion of the device. Furthermore, the shape andconfiguration of the handle 14 willoperate to enable determination ofthe relative rotational positioning of the device thereby permitting theoperator to discern with greater accuracy the point at which 90 degreesof relative rotation has occurred between thedevice 70 and the inserter10 with the device 70 in place within the uterine cavity. Additionally,the shape of the handle 14 will enable easy manipulation of the inserter10 to effeet the required rotation thereof for withdrawal from withinthe intrauterine device 70.

An additional advantage of the inserter 10 in determining orientationduring placement relates to the fact that the point of intersectionbetween the handle 14 and the forward body position is smooth on oneside but is formed with a sloped shoulder 69 on the opposite side. Thisenables determination of the direction of orientation of the slopedforward end. Thus, during insertion, it can be determined from theshoulder 69 whether the inserter is following the curvature of thecervical canal or is oppositely directed.

Although the present invention has been described in connection with aspecific intrauterine device 70 with which it is especially suitable foruse, it is to be understood that the shape and configuration of theintrauterine device which is placed by utilization of the inserter ofthe invention is not intended to constitute a limiting factor withregard to the scope of the invention, of which the intrauterine deviceforms no part. Any one of a variety of intrauterine devices which areappropriately shaped and configured to cooperate with the presentinvention may be utilized therewith. It will be clear, of course, thatthe intrauterine device must be appropriately sized and shaped foradequate mounting upon the inserter 10 but it should be understood thatmany modifications of the specific device 70 described herein may beeffected without affecting the performance of the present invention inthe placement of such a device.

It should be further understood that many modifications and variationsof the device of the present invention may be accomplished by thoseskilled in the art within the context of the present invention, and thatsuch variations and modifications are to be considered within the scopeand purview thereof.

What is claimed is: g

1. An intrauterine device inserter comprising a slender elongated body,and intrauterine device releasable retention means proximate one end ofsaid body for retaining an intrauterine device fixed thereon duringinsertion into a uterus and incorporating means enabling releasing ofsaid intrauterine device in disposition within a uterus from saidintrauterine device releasable retention means upon relative rotation ofsaid body with respect to said intrauterine device, said means enablingreleasing of said intrauterine device comprising a pair of notch meansof opposite sense located on one side of said body, said inserter beinggradually curved from approximately its midpoint to said pair of notchmeans, said pair of notch means being on the outside of the curve.

2. An inserter acording to claim 1 wherein said pair of notch meanscomprise a pair of notches.

3. An inserter according to claim 2 wherein said pair of notches arelongitudinally spaced apart a predetermined distance.

4. An inserter according to claim 1 wherein said end of said elongatedbody proximate said releasable retention means comprises a rectangularcross sectional configuration.

5. An inserter according to claim 4 wherein said rectangular crosssectional configuration includes a pair of 6. An inserter according toclaim 1 wherein said end of said elongated body proximate saidreleasable retention means is formed in a convex configuration at itsextremity.

7. An inserter according to claim 1 wherein the end of said elongatedbody opposite said releasable retention means comprises non-cylindricalhandle means configured to provide an indication of the rotativeorientation of said body about its long axis.

8. A inserter according to claim 1 wherein said elongated body comprisesmeans indicating on said body distances from said end proximate saidreleasable retention means.

9. An inserter according to claim 8 wherein said indicating meanscomprise variations increasing in crosssectional diameter from said endproximate said releasable retention means and formed in said elongatedbody.

10. An inserter according to claim 1 wherein said elongated bodyincludes cervical os abutment means thereon limiting insertion thereofof said inserter into a uterus.

11. An inserter according to claim 10 wherein said insertion limitingmeans comprise a pair of tabs formed on and extending laterally fromsaid elongated body.

12. An arrangement for placement of an intrauterine device in a uteruscomprising in combination an intrauterine device, an inserter having aslender elongated body, and intrauterine device releasable retentionmeans on one end of said body, said intrauterine device comprising aring and a membrane attached to said ring upon opposite sides thereofand extending therebetween, said intrauterine device releasableretention means comprising a pair of notches formed on one side of saidinserter, said ring engaged across said pair of notches on said one sideof said inserter, said membrane extending about the opposite side ofsaid inserter, whereby said intrauterine device is retained ininterlocked disposition on said inserter during insertion into a uterusand is released from said inserter in disposition within a uterus uponrelative rotation of said body with respect to said intrauterine device.

13. An arrangement according to claim 12 wherein said pair of notchesare longitudinally spaced a distance sufficient for enabling engagementof said ring within said notches whereby said intrauterine device may breleasably held upon said inserter. v

14. An arrangement according to claim 13 wherein said ring is resilientand wherein said longitudinal spacing of said notches is sufficient tocause flexure of said ring when engaged thereacross.

15. An arrangement according to claim 12 wherein said inserter comprisesa generally rectangular crosssectional configurationat least along thelength thereof proximate said pair of notches, said rectangularconfiguration defining a pair of shorter sides and a pair of longersides with said pair of notches being formed upon one of said shortersides and with said membrane shorter sides and a pair of longer sideswith said notch 0 extending about the other of said shorter sides.

means formed on one of said shorter sides.

1. An intrauterine device inserter comprising a slender elongated body,and intrauterine device releasable retention means proximate one end ofsaid body for retaining an intrauterine device fixed thereon duringinsertion into a uterus and incorporating means enabling releasing ofsaid intrauterine device in disposition within a uterus from saidintrauterine device releasable retention means upon relative rotation ofsaid body with respect to said intrauterine device, said means enablingreleasing of said intrauterine device comprising a pair of notch meansof opposite sense located on one side of said body, said inserter beinggradually curved from approximately its midpoint to said pair of notchmeans, said pair of notch means being on the outside of the curve.
 2. Aninserter acording to claim 1 wherein said pair of notch means comprise apair of notches.
 3. An inserter according to claim 2 wherein said pairof notches are longitudinally spaced apart a predetermined distance. 4.An inserter according to claim 1 wherein said end of said elongated bodyproximate said releasable retention means comprises a rectangular crosssectional configuration.
 5. An inserter according to claim 4 whereinsaid rectangular cross sectional configuration includes a pair ofshorter sides and a pair of longer sides with said notch means formed onone of said shorter sides.
 6. An inserter according to claim 1 whereinsaid end of said elongated body proximate said releasable retentionmeans is formed in a convex configuration at its extremity.
 7. Aninserter according to claim 1 wherein the end of said elongated bodyopposite said releasable retention means comprises non-cylindricalhandle means configured to provide an indication of the rotativeorientation of said body about its long axis.
 8. A inserter according toclaim 1 wherein said elongated body comprises means indicating on saidbody distances from said end proximate said releasable retention means.9. An inserter according to claim 8 wherein said indicating meanscomprise variations increasing in cross-sectional diameter from said endproximate said releasable retention means and formed in said elongatedbody.
 10. An inserter according to claim 1 wherein said elongated bodyincludes cervical os abutment means thereon limiting insertion thereofof said inserter into a uterus.
 11. An inserter according to claim 10wherein said insertion limiting means comprise a pair of tabs formed onand extending laterally from said elongated body.
 12. An arrangement forplacement of an intrauterine device in a uterus comprising incombination an intrauterine device, an inserter having a slenderelongated body, and intrauterine device releasable retention means onone end of said body, said intrauterine device comprising a ring and amembrane attached to said ring upon opposite sides thereof and extendingtherebetween, said intrauterine device releasable retention meanscomprising a pair of notches formed on one side of said inserter, saidring engaged across said pair of notches on said one side of saidinserter, said membrane extending about the opposite side of saidinserter, whereby said intrauterine device is retained in interlockeddisposition on said inserter during insertion into a uterus and isreleased from said inserter in disposition within a uterus upon relativerotation of said body with respect to said intrauterine device.
 13. Anarrangement according to claim 12 wherein said pair of notches arelongitudinally spaced a distance sufficient for enabling engagement ofsaid ring within said notches whereby said intrauterine device may bereleasably held upon said inserter.
 14. An arrangement according toclaim 13 wherein said ring is resilient and wherein said longitudinalspacing of said notches is sufficient to cause flexure of said ring whenengaged thereacross.
 15. An arrangement according to claim 12 whereinsaid inserter comprises a generally rectangular cross-sectionalconfiguraTion at least along the length thereof proximate said pair ofnotches, said rectangular configuration defining a pair of shorter sidesand a pair of longer sides with said pair of notches being formed uponone of said shorter sides and with said membrane extending about theother of said shorter sides.